I have a client in her 40s, living alone, who was told by her MD that her liver will probably fail. She has hepatitis C. She is not a candidate for a transplant at this time. She has other multiple health conditions and is bipolar. She advocates well for herself. Her MD told her to be as happy as possible. I am trying to contact the MD to get specific info. I will see her for maybe 1-2 more visits as a social worker for home care. She has a psychologist and psychiatrist. I arranged for therapeutic dog visits.
How can I support her? Which questions do I ask? How do I help her cope? She's upset and I am tongue tied. I endorsed her strengths and am helping her with some concrete needs.
Thanks.
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Therapist X
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Dear Therapist X,
It seems very reasonable that your client is upset right now. You could consider reflecting her actual feeling state. She is dealing with multiple
medical conditions, as well as being rejected for a transplant at this time - which might be a death sentence. Fortunately, she has some supports in
the form of her psychiatrist and psychologist, as well as the therapeutic dog visits that you have arranged. It sounds like you are anxious that you
will not be able to fulfill all her needs and change her life completely. We are not always able to fulfill our dreams for each person: it seems like
you would like to save your client from this difficult challenge she is facing. This is one of the hardest challenges therapists can face: helping
people cope with adversity while acknowledging that there are limits on what we can (and should) do.
As for what you can ask her to help her cope: perhaps you can ask her what has worked well for her in terms of her past coping, and suggest what is
physically possible for her at this time to continue ongoing. If she might benefit from company, are there friends or volunteers who could visit her?
Will she continue to have access to her mental health supports, or is she bed bound? Maybe she will need mental health treaters who can come to her
home (i.e. community care) until she is mobile? Perhaps she could attend in person or online support groups for people with similar medical issues -
sometimes hospitals run things like this. Finally, you might consider asking for consent to contact her current psychiatrist and psychologist to learn
more about their goals and any concrete services they might recommend.
Hatzlacha rabbah! Dr. Shoshi Lewin